The Determinants of Digital Quality and Safety Education for Nurses (QSEN); A Systematic Review

Abstract

The rapid advancement of digital technologies has transformed nursing education and expanded the ways nurses and nursing students develop quality and safety competencies. Digital learning, e-learning, virtual simulation, informatics-based education, and other technology-supported approaches are increasingly used to prepare nurses for safe, patient-centered, evidence-based, and high-quality care. Quality and Safety Education for Nurses (QSEN) provides a competency-based framework that emphasizes patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. However, the determinants influencing digital QSEN education remain dispersed across nursing education, informatics, patient safety, quality improvement, and digital learning literature. Therefore, this systematic review aimed to identify and synthesize the determinants of digital QSEN education among nurses and nursing students. Relevant studies addressing QSEN competencies, digital nursing education, e-learning, virtual simulation, informatics competence, patient safety education, teamwork, adverse event reporting, quality improvement, and digital self-efficacy were reviewed. A total of 30 studies were included and organized using a literature review matrix. The findings were synthesized narratively into educational, individual, clinical, organizational, and technological determinants. The review revealed that effective digital QSEN education is shaped by competency-based curriculum design, active digital learning strategies, informatics competence, digital health literacy, technology readiness, clinical relevance, leadership support, patient safety culture, and organizational readiness. Clarifying these determinants supports stronger digital nursing education and guides future research, curriculum development, and clinical practice planning.